Organization Active NPI

Richard W Kudrewicz, MD LTD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1437454162
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4400 Issued in NV
Legal business name
RICHARD W KUDREWICZ, MD LTD
Practice address
2820 W. Charleston Blvd.
C-27
Las Vegas, NV 89102-1942
Phone
(702) 877-9676
Fax
(702) 878-2119
NPI assigned
Jan 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Richard W Kudrewicz, MD
Title
M.D./Owner
Phone
(702) 877-9676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4400 NV Primary

Addresses

Primary practice location

2820 W. Charleston Blvd.
C-27
Las Vegas, NV 89102-1942

Mailing address

2820 W. Charleston Blvd.
C-27
Las Vegas, NV 89102-1942
Phone (702) 877-9676

National Provider Directory

National Provider Directory

Locations

2820 W Charleston Blvd
#C
Las Vegas, NV 89102
Phone (702) 877-9676

2820 W Charleston Blvd
#C27
Las Vegas, NV 89102
Phone (702) 877-9676

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1437454162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W. CHARLESTON BLVD.",
            "address_2": "C-27",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021942",
            "telephone_number": "702-877-9676",
            "fax_number": "702-878-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W. CHARLESTON BLVD.",
            "address_2": "C-27",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021942",
            "telephone_number": "702-877-9676",
            "fax_number": "702-878-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD W KUDREWICZ, MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "KUDREWICZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "702-877-9676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "4400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.